Journal Article10.1200/JCO.2002.11.013
Combination Chemotherapy and Radiotherapy for Primary Central Nervous System Lymphoma: Radiation Therapy Oncology Group Study 93-10
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TL;DR: This is the first multicenter trial demonstrating improved survival with the combination of chemotherapy plus RT compared with previous reports of RT alone, and high-dose methotrexate combined with cranial irradiation is an effective therapeutic approach to PCNSL, but neurotoxicity is a delayed risk of this approach.
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Abstract: PURPOSE: Primary CNS lymphoma (PCNSL) is an aggressive primary brain tumor. Cranial irradiation alone rarely results in long-term disease control or prolonged survival. We prospectively studied the use of combination chemotherapy plus cranial irradiation in newly diagnosed patients with PCNSL. PATIENTS AND METHODS: We enrolled 102 newly diagnosed, immunocompetent patients with PCNSL; 98 were assessable. Patients first received five cycles of methotrexate 2.5 g/m2, vincristine, procarbazine, and intraventricular methotrexate (12 mg). Whole-brain radiotherapy (RT) was administered to a total dose of 45 Gy and all patients received high-dose cytarabine after RT. RESULTS: Fifty-eight percent of patients with measurable disease had a complete response to preirradiation chemotherapy and 36% had a partial (> 50%) response, for a 94% response rate. Median progression-free survival was 24.0 months and overall survival was 36.9 months. Age was an important prognostic factor; median survival was 50.4 months in patie...
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Citations
Salvage whole brain radiotherapy for recurrent or refractory primary CNS lymphoma
TL;DR: Salvage whole brain radiation therapy (WBRT) is effective for recurrent and refractory primary CNS lymphoma and reserving WBRT until tumor recurrence is a reasonable strategy to minimize or delay the risk of treatment-related neurotoxicity.
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Methotrexate and temozolomide versus methotrexate, procarbazine, vincristine, and cytarabine for primary CNS lymphoma in an elderly population: an intergroup ANOCEF-GOELAMS randomised phase 2 trial.
Antonio Omuro,Olivier Chinot,Luc Taillandier,Hervé Ghesquières,Carole Soussain,Vincent Delwail,Thierry Lamy,Remy Gressin,Sylvain Choquet,Pierre Soubeyran,Aymeri Huchet,Alexandra Benouaich-Amiel,Sophie Lebouvier-Sadot,Emmanuel Gyan,Valérie Touitou,Maryline Barrie,Monica Sierra del Rio,Alberto González-Aguilar,Caroline Houillier,Daniel Delgadillo,Lucette Lacomblez,Marie Laure Tanguy,Khê Hoang-Xuan +22 more
TL;DR: Two promising methotrexate-based regimens, one more intensive and a milder regimen, were prospectively tested for primary CNS lymphoma in the elderly population, who account for most patients, and showed no evidence of late neurotoxicity.
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NOA‐03 trial of high‐dose methotrexate in primary central nervous system lymphoma: Final report
Ulrich Herrlinger,Wilhelm Küker,Martin Uhl,Hans-Peter Blaicher,Hans-Otto Karnath,Lothar Kanz,Michael Bamberg,Michael Weller +7 more
TL;DR: High‐dose methotrexate with deferred radiotherapy had only moderate efficacy and was associated with significant neurotoxicity in long‐term surviving patients.
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Comprehensive approach to diagnosis and treatment of newly diagnosed primary CNS lymphoma
Christian Grommes,James L. Rubenstein,Lisa M. DeAngelis,Andrés J.M. Ferreri,Tracy T. Batchelor +4 more
TL;DR: The epidemiology, clinical presentation, staging evaluation, prognosis, and current up-to-date treatment of immunocompetent PCNSL patients are overviewed.
High-dose chemotherapy with autologous haemopoietic stem cell transplantation for newly diagnosed primary CNS lymphoma: a prospective, single-arm, phase 2 trial.
Gerald Illerhaus,Benjamin Kasenda,Gabriele Ihorst,Gerlinde Egerer,Monika Lamprecht,Ulrich Keller,Hans-Heinrich Wolf,Carsten Hirt,Stephan Stilgenbauer,Mascha Binder,Peter Hau,Matthias Edinger,Norbert Frickhofen,Martin Bentz,Robert Möhle,Alexander Röth,Michael Pfreundschuh,Louisa von Baumgarten,Martina Deckert,Claudia Hader,Heidi Fricker,Elke Valk,Elisabeth Schorb,Kristina Fritsch,Jürgen Finke +24 more
TL;DR: HCT-ASCT with thiotepa and carmustine is an effective treatment option in young patients with newly diagnosed primary CNS lymphoma, but further comparative studies are needed.
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TL;DR: The addition of chemotherapy to cranial RT for initial treatment ofPCNSL significantly improved disease-free survival and contributed to overall survival; all non-AIDS patients with newly diagnosed PCNSL should be considered for combined modality therapy.
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